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Open enrollment for 2020 individual market coverage (on- and off-exchange) has ended. Outside of the open enrollment window, Ohio residents must have a qualifying event in order to purchase regular major medical coverage. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.

For 2020, ten insurers are offering plans in Ohio’s exchange, and nearly all of the state’s residents can select from among at least two insurers in the exchange. In 2018, residents in 42 of Ohio’s 88 counties had only one available insurer. That dropped to 16 counties in 2019, and thanks to coverage area expansions, Logan County is the only area of the state where just a single insurer offers exchange plans for 2020.

Ohio Medicaid/CHIP enrollment

Ohio’s acceptance of federal funding to expand Medicaid eligibility to 138 percent of poverty has played a significant role in the state’s success with Obamacare.

Between 2013 and July 2018, the state saw an increase of almost 600,000 people covered by Medicaid and CHIP. By late 2019, however, the net increase in Medicaid/CHIP enrollment in Ohio had dropped to under 500,000 people (in most states, Medicaid enrollment grew sharply for about two years after expansion was implemented, and then plateaued; in some cases, it has declined since then due to changes in the way a state verifies eligibility, improving economic conditions in the state, etc.).

Ohio does not allow renewal of short-term health insurance plans

The Trump administration relaxed the federal rules for short-term plans in 2018, allowing them to have much longer durations, including extensive renewals. But the new rules are clear in noting that states can impose stricter guidelines. Ohio allows short-term plans to have terms of up to 364 days, but renewals are prohibited.

How has Obamacare helped the Buckeye State?

Under the ACA, Ohio’s federally facilitated exchange and expanded Medicaid program both helped residents gain health coverage. During the first open enrollment period, equal numbers of people enrolled in private plans and Medicaid.

The state’s uninsured rate has dropped significantly as a result of the ACA, in large part due to the state’s expansion of Medicaid. According to U.S. Census data, Ohio’s uninsured rate stood at 6.5 percent in 2018, down from 11 percent in 2013. It had been even lower in 2017, but there has been a nationwide increase in the uninsured rate under the Trump administration.

Ohio and the Affordable Care Act

Ohio’s U.S. Senators are split on healthcare reform. Sherrod Brown, a Democrat, supports the ACA, while Rob Portman, a Republican, is a vocal opponent of the ACA.

Ohio’s state legislature has a strong Republican majority, and former Governor John Kasich, also a Republican, was not a fan of the ACA in general. (He didn’t see it as being effective in reducing healthcare costs and claimed it was “messing up the economy.”) So it’s no surprise that Ohio opted for a federally facilitated exchange rather than running its own exchange.

But Kasich broke ranks with most of his fellow Republican governors – and with his state’s legislature – in opting to expand Medicaid in Ohio. His reasoning was that it would have been immoral to not do so, and he’s vehemently challenged Republicans on this issue. Ohio’s average monthly Medicaid enrollment has grown by nearly half a million people since 2013. That’s a 23 percent increase, which far exceeds Medicaid growth in most states with Republican governors (the national average across all states, including those with Democratic leadership, has been 26 percent).

Kasich was term-limited and could not seek re-election in 2018. Republican Mike DeWine won the governor’s race, and took office in January 2019. DeWine has long opposed the ACA, but his position on Medicaid expansion appeared to soften as of 2018, when he said that the state would keep Medicaid expansion in place if he became governor. DeWine has served as the state’s attorney general since 2011. And while he joined in a lawsuit that year that challenged the constitutionality of the ACA, he did not join in the Texas v. Azar case, in which 18 GOP-led states are seeking to overturn the ACA.

Medicare enrollment in the state of Ohio

As of late 2019, there were more than 2.3 million Ohio residents enrolled in Medicare. You can read more about Medicare in Ohio, including details about Medicare Advantage and Part D prescription plans, as well as the specifics about Ohio’s rules for Medigap plans.

State-based health reform legislation

Scroll to the bottom of this page for a summary of recent Ohio bills related to health reform.